Your Registration Info

First Name *

Last Name *

Email Address *

Phone *

Street Address *

Zip Code *

Note

Course Registration Fees (Includes student textbook)

Course Registration Fees

COURSE FEE $99 - $ 99.00

Subsidized Course Fee - $ 72.00

Price Per Class - $ 20.00

I would like to sponsor another student - $ 99.00

I would like to dedicate a class in honor/memory of someone - $ 72.00

Total

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province

Postal Code

Looking forward to learning and discovering together!
- Chaya

info@jewishhamden.org | 203-684-6424 | P.O. Box 185641 Hamden, CT 06518